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homas Burke, 57; Helped Develop A Medicare Plan

Thomas R. Burke, a health economist and co-author of the Reagan Administration's failed effort to extend Medicare coverage to catastrophic illness, died on Monday at Alexandria Hospital in Virginia. An Alexandria resident, he was 57.

The cause was blood poisoning, his family said.

Mr. Burke was an official of the Department of Heath and Human Services when he and Dr. Otis R. Bowen, then chairman of an advisory committee studying Medicare, devised their plan. When Dr. Bowen became Secretary of the department in 1985 he named Mr. Burke as his chief of staff, and the "Bowen-Burke plan" became a legislative proposal with the imprimatur of the Reagan Administration.

The proposal was approved by Congress in June 1988 but was repealed about a year later, after an outpouring of criticism from Medicare beneficiaries who saw their premiums increase.

The measure drew intense fire from conservatives and liberals alike.

The mild-mannered Dr. Bowen bore their criticism. But it was his gruff "enforcer," Mr. Burke, who stood in the fiercest crossfire of the assault. Some critics called him a socialist, which he deeply resented.

Conservatives complained that the plan was far too expensive and that Mr. Burke was betraying President Reagan's principles. To liberal detractors, the foreseen coverage fell far short, and the elderly would be made to pay dearly for what little coverage there was.

He joined the Government as director of health-policy analysis in the Pentagon but moved to Health and Human Services as executive director of its Advisory Council on Social Security and later as special assistant in the Health Care Financing Administration.

Upon leaving the department in 1989 he became a principal partner of A. Foster Higgins & Company, a benefits consulting firm. Since 1991 he was president of the LaSalle Group, a health consulting firm in Washington.

Mr. Burke is survived by his wife, Sharon Bucs Burke; three daughters, Rosemary A., Heather M., and Kerry A. Burke, all of Alexandria; a son, Brendan T., of Kenosha, Wis.; a brother, J. George of Trenton, and two sisters, Mary B. Hazon of Trenton and Patricia Schwing of Andover, Mass.